Distribution of Brain HIV Load in AIDS
Clayton A. Wiley,Virawudh Soontornniyomkij,Lakshmi Radhakrishnan,Eliezer Masliah,John W. Mellors,Steve A. Hermann,Peter Dailey,Cristian L. Achim +7 more
TLDR
Assessment of overall brain viral load requires careful attention to regional quantitation, and selective regions, including basal ganglia and hippocampus, showed higher levels of virus than the cerebellar cortex and mid‐frontal cortical gray matter.Abstract:
Approximately one quarter of patients with AIDS develop severe cognitive deficits called HIV-associated dementia complex (ADC). There is some controversy regarding the importance of viral load in mediating neurologic disease. With the advent of sensitive, quantitative and reproducible RNA assays for HIV load in plasma and CSF, we quantified viral load in brains from 10 autopsied HIV-infected subjects and 2 non-infected controls. The new quantitative HIV RNA assays showed general agreement with previously used semi-quantitative immunocytochemical assessments of HIV envelope protein, and were performed without professional subjective interpretation. All cases with very high levels of HIV in the CSF, had high overall levels in the brain, suggesting that CSF viral loads exceeding 10(6) copies per mL may be a surrogate marker of high viral load in the brain. Levels of virus in the spleen showed no clear association with those found in the brain. HIV RNA was not uniformly distributed throughout the brain. Selective regions, including basal ganglia and hippocampus, showed higher levels of virus than the cerebellar cortex and mid-frontal cortical gray matter. Assessment of overall brain viral load requires careful attention to regional quantitation.read more
Citations
More filters
Journal ArticleDOI
Pathways to neuronal injury and apoptosis in HIV-associated dementia
TL;DR: Human immunodeficiency virus-1 (HIV-1) can induce dementia with alarming occurrence worldwide, but discovery in brain of HIV-1-binding sites (chemokine receptors) provides new insights.
Journal ArticleDOI
Cognitive Neuropsychology of HIV-Associated Neurocognitive Disorders
TL;DR: An update on the nature, extent, and diagnosis of HAND is provided and the cognitive neuropsychology approach may enhance the ecological validity of neuroAIDS research and inform the development of much needed novel, targeted cognitive and behavioral therapies.
Journal ArticleDOI
HIV and antiretroviral therapy in the brain: neuronal injury and repair.
TL;DR: By carefully selecting specific antiretrovirals and supplementing them with neuroprotective agents, physicians might be able to facilitate innate CNS repair, promoting enhanced synaptodendritic plasticity, neural function and clinical neurological status.
Journal ArticleDOI
Human immunodeficiency virus‐associated neurocognitive disorders: Mind the gap
TL;DR: This review attempts to answer why there appears to be a therapeutic gap between the salutary effects of antiretroviral regimens and normalization of neurological function, and discusses the animal models that have helped to elucidate these mechanisms.
Journal ArticleDOI
Blood-brain barrier tight junction disruption in human immunodeficiency virus-1 encephalitis.
Linda M. Dallasta,Liubomir A. Pisarov,James E. Esplen,Jonette Werley,Ashlee V. Moses,Jay A. Nelson,Cristian L. Achim +6 more
TL;DR: It is proposed that disruption of this key BBB structure serves as the main route of HIV-1-infected monocyte entry into the CNS during human immunodeficiency virus encephalitis.
References
More filters
Journal ArticleDOI
Rapid turnover of plasma virions and CD4 lymphocytes in HIV-1 infection
TL;DR: Treatment of infected patients with ABT-538 causes plasma HIV-1 levels to decrease exponentially and CD4 lymphocyte counts to rise substantially, indicating that replication of HIV- 1 in vivo is continuous and highly productive, driving the rapid turnover ofCD4 lymphocytes.
Journal ArticleDOI
HIV-1 Dynamics in Vivo: Virion Clearance Rate, Infected Cell Life-Span, and Viral Generation Time
TL;DR: A new mathematical model was used to analyze a detailed set of human immunodeficiency virus-type 1 (HIV-1) viral load data collected from five infected individuals after the administration of a potent inhibitor of HIV-1 protease, providing not only a kinetic picture ofAIDS pathogenesis, but also theoretical principles to guide the development of treatment strategies.
Journal ArticleDOI
Prognosis in HIV-1 Infection Predicted by the Quantity of Virus in Plasma
John W. Mellors,Charles R. Rinaldo,Phalguni Gupta,Roseanne M. White,John Todd,Lawrence A. Kingsley +5 more
TL;DR: Plasma viral load was a better predictor of progression to AIDS and death than was the number of CD4+ T cells, and the risk of acquired immunodeficiency syndrome (AIDS) and death in study subjects was directly related to plasma viral load at study entry.
Journal ArticleDOI
The AIDS Dementia Complex
Richard W. Price,Bruce J. Brew +1 more
TL;DR: The views of the current state of knowledge regarding the etiology, clinical presentation, and diagnostic and therapeutic approaches to the AIDS dementia complex are presented.
Journal ArticleDOI
The AIDS dementia complex: II. Neuropathology
TL;DR: The AIDS dementia complex is established as a distinct clinical and pathological entity and, together with accumulating virological evidence, suggests that it is caused by direct LAV/HTLV‐III brain infection.